Purpose: The purpose of this study was to compare the anesthetic requirements and hemodynamic and oxygenation variables involved between the bolus midazolam/fentanyl intravenous sedation-analgesia technique, and the same technique combined with continuous-infusion propofol.
Patients and methods: This was a retrospective chart analysis of 41 consecutive patients undergoing full-face carbon dioxide laser resurfacing with either bolus midazolam/fentanyl (n = 15) or midazolam/fentanyl with continuous propofol infusion anesthesia (n = 26) techniques. Data recorded were noninvasive baseline and intraoperative hemodynamic measurements at 5-minute intervals for systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP), pulse (P), and rate-pressure product (RPP), respiratory rate (RR), and oxygen saturation (SpO2). Data collected were reported as mean values with standard deviation. Statistical analyses were performed with the Student's t test and found statistically significant for P < .05.
Results: Statistically significant decreases in averages were seen in SBP (P < .001), DBP (P = .02), MAP (P = .004), P (P < .00l), RPP (P < .00l), and RR (P < .001), but not PP (P = .4) and SpO2 (P = .08) in the midazolam/fentanyl/continuous propofol infusion group compared with the midazolam/fentanyl only group. Changes from baseline were statistically significant only for MAP (P = .04), but statistically insignificant for all other measurements, SBP (P = .7), DBP (P = .4), P (P = .95), PP (P = .97), RPP (P = .6), RR (P = .6), and SpO2 (P = .4). Statistically significant smaller amounts of midazolam (P = .01) and fentanyl (P < .001) were used in the midazolam/fentanyl/continuous propofol infusion pump group. Length of procedure was statistically insignificant between groups (P = .4). Conclusion The addition of a continuous propofol pump maintained hemodynamic and oxygenation values close to baseline, while decreasing the amount of respiratory depressing opiates administered and without affecting the length of the procedure.